Unknown Primary Cancer

Has anyone had this diagnosis? I have read of it in cancer book and we are
trying to figure out type cancer, if any, friend has. She has lots of pain
in area under breast, nothing showed up on x-ray. She did have an MRI for
back problem and was told a "black" area appeared under arm, as well as one
in back. Specimen sent for back area which will take several days. I am
also wondering if it is costochronditis rather than breast cancer. Any
thoughts appreciated.

Hoosier wrote:
> Has anyone had this diagnosis? I have read of it in cancer book and we are
> trying to figure out type cancer, if any, friend has. She has lots of pain
> in area under breast, nothing showed up on x-ray. She did have an MRI for
> back problem and was told a "black" area appeared under arm, as well as one
> in back. Specimen sent for back area which will take several days. I am
> also wondering if it is costochronditis rather than breast cancer. Any
> thoughts appreciated.
>
>
The diagnosis "cancer of unknown primary" is given when secondary cancer
is diagnosed, but no primary has been found and the cells are too poorly
differentiated to be identified under a microscope.

Obviously if the abnormality has not been positively identified as
cancer then this diagnosis cannot be made.

When this condition does occur it usually means that the 'occult'
primary is very advanced and aggressive, and so the prognosis is poor.

However it doesn't sound very likely to be associated with chest pain,
and I'm sure a doctor would be keen to rule out every other possible
cause before making this diagnosis, it is very much a diagnosis of last
resort, usually when faced with what appear to be the unexplained late
stage symptoms of terminal cancer such as multiple metastases, high
levels of certain 'marker' compounds in the blood, and Cachexia (wasting).

Oddities showing up in perfectly healthy people on an MRI scan are not
unusual, and may be totally unrelated to the symptom.

The symptom in question is chest pain, this would only be related to a
back problem if the latter involved the vertebra through which the chest
nerves join the spinal cord. Pressure here can cause a band of pain
around the chest, lower down than the vertebra in question. Such pains
tend to reduce with mild exercise, whereas costochondritis tends to
increase. If the pain is responsive to anti-inflammatories such as
Ibuprofen, that would also tend to indicate an inflammatory process
rather than a growth. But of course don't go experimenting with such
treatment without the doctor's advice.


Tim Jackson

"Hoosier" <dbldare@k-inc.com> wrote in message
news:12krpltejsvkk3f@corp.supernews.com...
> Has anyone had this diagnosis? I have read of it in cancer book and we
> are
> trying to figure out type cancer, if any, friend has. She has lots of
> pain
> in area under breast, nothing showed up on x-ray. She did have an MRI for
> back problem and was told a "black" area appeared under arm, as well as
> one
> in back. Specimen sent for back area which will take several days. I am
> also wondering if it is costochronditis rather than breast cancer. Any
> thoughts appreciated.
>
I had a patient many years ago with a similar presentation. He had chest
pain in a localized area of the back. There was a lytic lesion--something
had destroyed and replaced bone, leaving a black area compared to the
white-colored bone on x-ray. That proved, as Tim warned, to be a rather
wild type of cancer. We could find no primary then, but later he showed up
with a primary in the lungs. I had another patient about the same era who
had fluid collapsing both lungs and fluid in the abdomen. We removed some
of the fluid from each location for diagnostic purposes. It had malignant
cells that tended to cluster in a way that suggested primary ovarian cancer.
Neither the general surgery service nor the gynecology service were
muchinterested in doing an exploration to look for a primary tumor, but
ultimately, based on the pathologist's impression and much arm-twisting by
the medical service, the gynecologists did do a laparotomyand found a small
primary tumor in the ovaries.

Thanks for responses. There has been no biopsy taken as yet since there is
nothing showing up to biopsy. She did have a PET scan taken yesterday (I am
thinking they are very concerned since it was Sunday, not usually a day for
tests). We are thinking it may well be an advanced cancer throughout body,
but hope not.


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